Strength of Occipital Hair as an Explanation for Pilonidal Sinus Disease Caused by Intruding Hair

Doll, Dietrich; Bosche, Friederike; Stauffer, Verena K.; Sinicina, Inga; Hoffmann, Sebastian; Zypen, Dominic van der; Luedi, Markus M.

doi:10.1097/dcr.0000000000000795

Cited by 43 publications

(37 citation statements)

References 26 publications

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“…Cut hair fragments from occipital region were found in pilonidal nest which suggests that disease is related to this particular region as source. In concordance to their study authors are suggesting reduction in production of hair fragments in occipital (for example by shaving), removing cut hair along dorsal crest, reducing contact with hair within intergluteal fold such as with promptly showers after a hair cut in persons at risk [8].…”

Section: Incidence and Risk Factorssupporting

confidence: 79%

Pilonidal Disease

Nestorović

Pecić²,

Branković³

et al. 2019

FU Med Biol

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Pilonidal disease is a common and well-recognized medical condition. It affects people in reproductive age, especially men and in combination with in-patient and outpatient treatment and absence from work it causes a considerable socioeconomic loss. This fact led to a renewed interest in understanding of the disease and search for the ideal method of treatment. The purpose of this review was to provide update on therapeutic options for patients with pilonidal disease. In case of chronic or recurrent pilonidal disease various treatment options exist, addressing different measures of surgical outcome. Like for many conditions, there is increase in the use of minimally invasive techniques in the treatment, which could be alternative to surgical excisions for pilonidal disease. Procedures for treatment of pilonidal disease can be divided in two large groups: minimally invasive treatment and excisional procedures. Although various treatment options exist nowadays, surgery is still preferred as definitive treatment. The optimal closure of the wound following an excision is still under debate since outcome measures depend mostly on type of closure selected. Most of the procedures fail to achieve the goals altogether. The final decision on treatment should be made based on surgeon and the patient’ preference.

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Section: Incidence and Risk Factorssupporting

confidence: 79%

Pilonidal Disease

Nestorović

Pecić²,

Branković³

et al. 2019

FU Med Biol

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“…2 They acknowledge that stronger, razor-sharp cut hairs from the head (as seen in Figure 1), accumulating between the buttocks and piercing the healthy skin, 3 may be the source of pilonidal sinus disease. 4,5 We agree with the majority of conclusions in the guidelines, but several topics are controversial at best.…”

Section: New Attempt To Reach a Common Sense In Pilonidal Sinus Therapysupporting

confidence: 66%

New Attempt to Reach a Common Sense in Pilonidal Sinus Therapy

Doll

Luedi

2019

Diseases of the Colon &Amp; Rectum

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To the Editor-In his letter, Dr Tomassi describes his study from Kaiser Permanente Southern California, in which the investigators "expectantly managed" 378 patients with high-grade anal dysplasia, demonstrating an incidence rate of 0.19% per patient-year for anal squamous cell carcinoma (SCC). This rate is lower than the rate we identified using the population-based cancer registries of the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute. It must be emphasized that Dr Tomassi's data derive from Kaiser Permanente billing codes, and therefore all included patients are medically insured. As Dr Tomassi states in his letter, surveillance of patients at high risk for anal SCC is provided by "general and colorectal surgeons, infectious disease specialists, family medicine and internal medicine physicians, and gynecologists." The Kaiser Permanente data come from a large integrated managed care group that receives high marks for quality of care with an emphasis on preventive care and access to care. This likely represents a higher level of longitudinal care than most patients in the United States are fortunate enough to receive. Our SEER data are derived from 34.6% of the US population, irrespective of insurance status, and are Data from different sources have different applications: for a large healthcare system or insurance organization looking to allocate resources and determine policy for a population, we commend the use of the Kaiser data. For a surgical practitioner counseling his or her patients, we commend data such as our own. We share with our crosstown colleagues the clinical conclusion that expectant management of HSIL is reasonable, based on evidence and experience. We wonder if we can now call it San Diego rather than expectant management, to use a sunnier and less pregnant term! We also share with everyone in the field, including advocates of HSIL ablation with whom we disagree, the conviction that people at high risk for anal cancer should be followed regularly by practitioners accustomed to examining the anus. Indurated or ulcerated lesions should be biopsied so that early stage cancers can be detected and cured.

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“…Die Haare spielen eine zentrale Rolle in der Entstehung des Pilonidalsinus [3,4]. Doll und Kollegen wiesen in 2017 nochmals auf die wesentliche Rolle der Haare im Pathomechanismus hin [5]. Jedoch kann nicht davon ausgegangen werden, dass die aufgefundenen Schnitthaare im Bereich eines Porus auch dort entstanden sind.…”

Section: Pathomechanismusunclassified

Sinus pilonidalis – was ist die beste chirurgische Therapie?

Petersen

2019

Zentralbl Chir

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Zusammenfassung Einleitung Der Sinus pilonidalis ist eine meist chronische punktuelle Infektion der behaarten Haut im Bereich von Hautfalten mit der häufigsten Lokalisation im Bereich der Rima ani. Die Erkrankung hat oft erhebliche Auswirkung auf die Lebensqualität der Betroffenen, die Behandlung kann komplex sein und muss dem Patientenbedarf angepasst werden. Methoden Im Folgenden wird eine Übersicht über die Entstehung sowie die Behandlungsalternativen und deren Besonderheiten gegeben. Dabei werden jeweils die Aspekte frühe postoperative Ergebnisse, Wundheilungsstörung und Langzeitergebnisse dargestellt. Ergebnisse Der Pathomechanismus der Pilonidalsinus-Erkrankung ist weiterhin nicht abschließend geklärt, es muss auch weiterhin davon ausgegangen werden, dass die Haare in der Rima ani wesentlich zu Entstehung beitragen. Neuere Erkenntnisse weisen jedoch darauf hin, dass die großen Haarbüschel, die immer wieder in der Wundhöhle gefunden werden, am ehesten von der behaarten Kopfhaut stammen. Es lassen sich im Wesentlichen 3 Gruppen der Behandlungsoptionen unterscheiden: Die Standardbehandlung der Exzision und die folgende offene Wundbehandlung hat eine geringe Rezidivrate, weist jedoch erheblichen Aufwand im Rahmen der Wundbehandlung auf und führt dadurch zu langer Krankheitsdauer. Relativ neu in den Fokus geraten sind die lokal destruierenden Behandlungsverfahren, welche die Haut im Wesentlichen erhalten. Wichtige Vertreter sind das sog. Pit Picking, Fistuloskopie und andere Behandlungsformen wie Phenolinjektion oder Laserbehandlung. Bei diesen Behandlungsmöglichkeiten steht die abschließende Bewertung der Ergebnisse noch aus. Die 3. Behandlungsgruppe umfasst die Exzision und plastisch-rekonstruktive Verfahren. Diese Verfahren sind technisch aufwendig, gehen häufig mit stationärer Behandlung einher und führen langfristig jedoch zu relativ guten Ergebnissen. Schlussfolgerung Die Pilonidalsinus-Behandlung erfordert eine am Patienten orientierte Therapieplanung. Dabei müssen dem Patienten die unterschiedlichen Behandlungsoptionen vermittelt werden und eine Behandlungsempfehlung muss ausgesprochen werden. Hier dient die Exzision und offene Wundbehandlung weiterhin als Standardverfahren, anhand dessen die Vor- bzw. Nachteile der anderen Behandlungsoptionen vermittelt werden können.

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Strength of Occipital Hair as an Explanation for Pilonidal Sinus Disease Caused by Intruding Hair

Cited by 43 publications

References 26 publications

Pilonidal Disease

Pilonidal Disease

New Attempt to Reach a Common Sense in Pilonidal Sinus Therapy

Sinus pilonidalis – was ist die beste chirurgische Therapie?

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